Primary prevention programs to reduce heart disease risk in women.

Cardiovascular disease is the number one killer of women. Despite this statistic, many women do not perceive heart disease as a priority health concern. Recognizing that prevention begins in the community, the American Hospital Association launched a national fellowship program in 1998 to improve cardiovascular health. This article describes a practice innovation designed by a clinical nurse specialist who participated as a 1999-2000 cardiovascular fellow. The Women's Prevention Center, a community-based clinic within the walls of a heart hospital, provides a personalized cardiovascular assessment for women, including both heart history and assessment of physical parameters (eg, blood pressure, fasting glucose, lipid panel, waist-hip ratio). From this assessment, women are counseled on strategies to modify their individual risk factors, such as smoking cessation, heart-healthy nutrition and exercise, and are assisted in developing realistic lifestyle or medical management goals. After the initial assessment, outcomes are measured at 3-, 6-, and 12-month follow-ups to determine both individual success with behavior changes and program effectiveness.